# DIANNE M. GREJTAK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Specialty Shoppe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891872719
- **Authorized official:** MS. DIANNE M. GREJTAK (OWNER)
- **Authorized official phone:** (210) 614-3360

## Contact information

- **Practice address:** 4944 RESEARCH DR, SAN ANTONIO, TX 78240-5006
- **Practice address phone:** (210) 614-3360
- **Practice address fax:** (210) 614-3362
- **Mailing address:** 4944 RESEARCH DR, SAN ANTONIO, TX 78240-5006
- **Mailing address phone:** (210) 614-3360
- **Mailing address fax:** (210) 614-3362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0065742 | TX | Yes |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 0065742 | TX | — |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/29/2011